Mr. Chair, I am pleased to speak to the issue of cross-border drug sales and the federal strategy to help ensure an adequate supply of safe and affordable drugs.
I am fully aware that quality, efficacy, supply and pricing of pharmaceutical drugs are important topics to many Canadians, including my constituents of Brampton—Springdale.
When we discuss this issue, one of the most troubling points is the way in which some doctors have begun co-signing some of the prescriptions for patients from the United States whom they have neither seen nor examined. As a former health care practitioner, this indicates to me a misuse of prescribing authority, encourages poor prescribing habits and is a potential threat to patient safety.
It has become apparent that some Internet based pharmacies do not require patients to visit a Canadian doctor to obtain a Canadian prescription. Instead, the Internet pharmacies are asking Canadian physicians to co-sign prescriptions for patients they have never seen. This practice has come to the attention of the government through the cross-border drug sales that are occurring. A prescription issued in the absence of an established patient-practitioner relationship raises significant safety concerns, regardless of whatever the originating circumstance is.
The principal motivation, from the research that I have done and that we have determined from this initiative, in co-signing cross-border prescription is to facilitate commerce and not to ensure patient safety.
Provincial and territorial colleges of medicine and other regulatory authorities are responsible for the practice of medicine and for ensuring that there is a patient-practitioner relationship. They have called the practice of co-signing prescriptions outside of an established patient-practitioner relationship disgraceful and unprofessional. I am sure that many Canadians and other stakeholders involved in this initiative will agree. These colleges and regulatory authorities have taken disciplinary against physicians who have engaged in this unfortunate practice.
From the federal government's point of view, the practice also raises questions about the quality of care and patient safety.
The food and drug regulations require, as a condition of sale, that prescription drugs be sold only if authorized by a practitioner who is licensed to practice in Canada.
Canada health care practitioners conduct a risk and benefit assessment prior to prescribing a drug to a patient. They meet with a patient. They evaluate the patient and then this forms the foundation of their clinical evaluation. This allows for an appropriate level of interaction to weigh the risks and the benefits of a patient using a particular type of prescription drug.
Fundamental to promoting the safe use of prescription drugs is a need to ensure that Canadians continue to benefit from the knowledge and the expertise of health care professionals who have gone to school for many years before those patients take prescription products.
This is why the Minister of Health is consulting with the Canadian public and stakeholders to discuss optimal implementation of a proposed regulatory amendment to the Food and Drugs Act. This proposed amendment would require that prescription drugs be sold pursuant to a prescription issued with an established patient and practitioner relationship.
Provinces and territories, as we all know, are responsible for the regulation of the practice of medicine and pharmacy. This responsibility has been delegated to them by the colleges and registrars of medicine and pharmacy in each and every province and territory in our country.
Provincial and territorial regulatory authorities have indicated that some Canadian health practitioners have begun co-signing prescriptions without ever undertaking an appropriate assessment of the patient. These bodies have stated that this practice is simply unethical and is not part of a sound medical practice on which many Canadian family physicians and practitioners pride themselves.
Thus, the dispensing of drugs that have been prescribed in this manner is of great concern not only to the regulatory bodies but to many other Canadians and this Minister of Health and parliamentary secretary.
The Federation of Medical Regulatory Authorities of Canada has stated that it is its position that physicians should only prescribe in the context of an established patient-physician relationship to ensure continuity of care and to ensure that appropriate information is transmitted to the patient. This includes telephone prescribing, Internet prescribing, countersigning of prescriptions and electronic prescribing.
The Food and Drugs Act and the food and drug regulations set out very general prohibitions and provisions for the sale and the advertisement of drugs in Canada and their standard of manufacturing. These include very specific requirements for the sale of prescription drugs because of their inherent health risks.
However the regulations that are currently underway do not explicitly require, as a condition of sale, that a prescription be issued pursuant to an established patient and practitioner relationship.
The inclusion of a regulatory requirement for an established patient-practitioner relationship as a condition of sale of prescription drugs would complement and reinforce existing provincial and territorial rules and also enhance our federal regulations, standards and guidelines.
In doing so, the intention is to enhance the protection of patient safety in relation to the sale of prescription drugs. The co-signing of U.S. prescriptions by Canadian physicians has highlighted the need for us as Parliament and as a House to address this very important issue. The planned requirement would apply equally to all prescription drug sale situations. This is a very important topic that is of great concern to many Canadians and to the health care professionals.
